Clocker, Candace Renee

Clocker, Candace Renee is an sole proprietor health care provider with primary practice located at 2100 Wilborn Ave , South Boston VA 24592-1628. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Primary Care. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Clocker, Candace Renee can be contacted via phone (434) 517-8022.

Contact Information

Primary practice address
2100 Wilborn Ave South Boston VA 24592-1628
Phone: (434) 517-8022
Fax: (434) 517-8370
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2013-01833 North Carolina
Ambulatory Health Care Facilities / Primary Care 261QP2300X 33110 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101261852 Virginia

Profile Details

NPI number 1841488905
LBN Legal business name Clocker, Candace Renee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2007
Last updated Mar 7th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841488905 NPPES
South Carolina Other 33110 LICENSE NUMBER

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